What role does compassion have on quality care ratings? A regression analysis and validation of the SCQ in emergency department patients.

Objective: To examine the unique contribution of patient reported experiences of compassion to overall patient quality care ratings. Additionally, we assess whether patients' reported experiences of compassion in the emergency department differed between sociodemographic groups.

Methods: Provincial data for this cross-sectional study were collected from 03/01/2022 to 09/05/2022 from 14 emergency departments in Alberta, Canada. Data from 4501 emergency department patients (53.6% women, 77.1% White/European) were analyzed. The primary outcome was patients' overall quality care ratings during their most recent ED visit. Measures included in the hierarchical stepwise regression included demographics, and those drawn from the Emergency Department Patient Experience of Care (EDPEC) questionnaire: single and multi-item measures of patient information (e.g., patient perceptions health) and patient experience (e.g., physician communication), and compassion (e.g., Sinclair Compassion Questionnaire; SCQ-ED).

Results: Data from 4501 ED patients were analysed. Stepwise hierarchical linear multiple regression indicated that of 21 included variables, compassion most strongly predicted overall quality care ratings (b=1.61, 95% CI 1.53-1.69, p<.001, f=.23), explaining 19% unique variance beyond all other measures. One-way ANOVAs indicated significant demographic differences in mean compassion scores, such that women (vs. men) reported lower compassion (MD=-.15, 95% CI=-.21, -.09, p<.001), and Indigenous (vs. White) patients reported lower compassion (MD=-.17, 95% CI =-.34, -.01, p=.03).

Conclusions: Compassion was identified as a key contributor to ED overall quality care ratings, and experiences of compassion varied as a function of demographics. Patient-reported compassion is an indicator of quality care that needs to be formally integrated into clinical care and quality care assessments.